Substance Use Disparities among E-cigarette and Combustible Cigarette Users, Dual Users, and Nonusers: Comparing Heterosexual and Sexual and Gender Minority Adolescents

Objective: In this paper, we examine substance use disparities among heterosexual and sexual and gender minority adolescent e-cigarette and combustible cigarette users, dual users, and non-users in West Virginia (WV). Methods: With the 2021 WV Youth Risk Behavior Survey (N = 483) as our data set, we used chi-square tests to examine the hypothesis of equal proportions across sexual and gender minority (SGM) groups for selected tobacco product and substance use variables. Logistic regression models for each tobacco product then determined whether the SGM groups were at greater risk for engagement in other substance use. Results: SGM females reported higher lifetime use of e-cigarettes and combustible cigarettes, and a greater proportion were dual users (p < .05). Regression models revealed greater likelihood of electronic cigarette use (OR = 5.65, p < .0001), combustible cigarette use (OR = 3.53, p < .0001), and dual users (OR = 3.66, p < .0001) among those who also reported the use of more substances compared to nonusers; however, non-significant interaction tests suggest the response to the use of more substances is similar for heterosexual and SGM groups. Conclusions: Tobacco product use remains elevated in this sample, especially among SGM females. However, all groups were at greater risk for the engagement in other substance use if they engaged in any form of tobacco product use regardless of sexual orientation.